HESI NUTRITION ACTUAL EXAM 140 QUESTION AND CORR ECT DETAILED ANSWERS WITH RATIONALES RATED A GRADE. While a nurse is teaching a client with diabetes about food choices, the client states, "I do not like broccoli." Which food should the nurse suggest to substitute for broccoli? - ANSWER -greenbeans According to exchange lists for meal planning, green beans and broccoli are equivalent vegetable substitutes. Peas are a starch and are not an equivalent vegetable substitute for broccoli. Corn is a starch and is not an equivalent vegetable substitute for broccoli. Mashed potato is a starch and is not an equivalent vegetable substitute for broccoli. n older adult is returned to the surgical unit after having a subtotal gastrectomy. Which dietary modification should the nurse anticipate that the healthcare provider will most likely prescrib - ANSWER -small feedings Small, frequent feedings are tolerated best after a subtotal gastrectomy. Roughage may be irritating to the gastrointestinal (GI) tract after surgery. As soon as edema subsides, the individual generally is given small amounts of fluid, and then the diet is progressed gradually. Allowing only personal food preferences does not ensure inclusion of nutrients necessary for recovery. A client is experiencing an exacerbation of ulcerative colitis. A low -residue, high -protein diet and IV fluids with vitamins have been prescribed. When implementing these prescriptions, which goal is the nurse trying to achieve? - ANSWER -reduce colonic irritation A low -residue diet is designed to reduce colonic irritation, motility, and spasticity. Reduction of gastric acidity is the aim of bland diets used in the treatment of gastric ulcers. Reducing colonic irritation, motility, and spasticity hopefully will increase, not reduce, intestinal absorption. This diet is to allow the bowel to rest, not to reduce infection rates. Which food should be avoided by a client who is prescribed monoamine oxidase inhibitors (MAOIs)? - ANSWER -bologna Bologna has a high tyramine content; tyramine should not be consumed by clients taking monoamine oxidase inhibitors (MAOIs) because the drug interaction may cause severe hypertension. Potatoes and citrus fruits do not contain tyramine. Grapefruit juice may cause a negative drug interaction in clients taking buspirone . celiac disease - ANSWER -lifelong The diet must continue to be followed because the child will always have an absence of peptidase; some variations in the diet may be allowed, but this should not be promised. Each phase of child development may have problems related to dietary management; follow -up care is needed to prevent crises. A restricted diet is never easy to follow, especially for a growing child. Gluten must be avoided for a prolonged period and perhaps indefinitely. A client with a history of a pulmonary embolus is to receive 3 mg of warfarin daily. The client has blood drawn twice weekly to ascertain that the international normalized ratio (INR) stays within a therapeutic range. The nurse provides dietary teaching. W hich food selected by the client indicates that further teaching is necessary? - ANSWER -spinach Dark green, leafy vegetables are high in vitamin K. Influencing the level of vitamin K alters the activity of warfarin because vitamin K acts as a catalyst in the liver for the production of blood -clotting factors and prothrombin. The intake of foods conta ining vitamin K must be consistent to regulate the warfarin dose so that the INR remains within the therapeutic range. Eggs contain protein and are permitted on the diet. Yellow vegetables contain vitamin A and are permitted on the diet. Dairy products containing protein and bread supplying carbohydrates are permitted on the diet Which recommendation is most important for the nurse to include in a teaching program for a client who has been placed on a 2 -gram sodium diet? - ANSWER -use lemon juice to flavor meat Lemon juice adds flavor and is low in sodium. Condiments (e.g., mustard, ketchup) are high in sodium and should be avoided. Canned vegetables contain a large amount of sodium; fresh vegetables should be encouraged. Carbonated beverages generally contain so dium; coffee, even if it is decaffeinated, does not contain sodium . cirrhosis of the liver - ANSWER -pasta banana A client with cirrhosis and ascites will require moderate to low fat and low sodium (penne pasta, spinach, banana, and decaffeinated iced tea). Caffeine can stimulate and cause distention. Ham, cheese, whole milk, potato chips, baked lasagna with sausage, milkshake, hamburger, french fries, and cola all have more fat and sodium than a client with cirrhosis should consume. hypokalemia - ANSWER -brocoli Potassium is plentiful in green leafy vegetables; broccoli provides 207 mg of potassium per half cup. Oatmeal provides 73 mg of potassium per half cup. Rice provides 29 mg of potassium per half cup. Cooked fresh carrots provide 172 mg of potassium per half cup; canned carrots provide only 93 mg of potassium per half cup. A nurse evaluates that a client with chronic kidney disease understands an adequate source of high biologic -value (HBV) protein when the client selects which food from the menu? - ANSWER -cottage cheese Cottage cheese contains more protein than the other choices. Apple juice is a source of vitamins A and C, not protein. Raw carrots are a carbohydrate source and contain beta -carotene. Whole wheat bread is a source of carbohydrates and fiber. A nurse is planning an evening snack for a child receiving NPH insulin. What is the reason for this nursing action? - ANSWER -nourishment counteracts late insulin activity A bedtime snack is needed for the evening. NPH insulin is intermediate -acting insulin, which peaks 4 to 12 hours later and lasts for 18 to 24 hours. Protein and carbohydrate ingestion before sleep prevents hypoglycemia during the night when the NPH is stil l active. The snack is important for diet -insulin balance during the night, not encouragement. There are no data to indicate that extra calories are needed; a bedtime snack is routinely provided to help cover intermediate -acting insulin during sleep. The s nack must contain mainly protein -rich foods, not simple carbohydrates, to help cover the intermediate -
acting insulin during sleep. A parent is worried about the infant's excessive dependence on nonnutritive sucking. Which intervention will help decrease this dependence? - ANSWER -
prolong feeding time An infant's dependence on nonnutritive sucking can be reduced by prolonging the feeding time, so that the sucking pleasure is increased. Using infant formulas will not help prevent nonnutritive sucking, because the child needs the pleasure of sucking. Usin g a pacifier as soon as the crying begins increases the child's dependence on nonnutritive sucking, because it reinforces a pattern of distress -relief. Wrapping the infant snugly most of the time may not be possible, because it may cause the infant to feel uncomfortable. new salmonella - ANSWER -ask about the past 24 hour foods
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